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COVID-19 and the state of politics (Read 30281 times)

Oldmanmatt

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#75 Re: COVID-19 and the state of politics
April 03, 2020, 05:06:44 pm
So, the Queen’s address on Sunday.

“Thanks key workers” or “We regret to announce, terrible x, horrific y and a really awful z”?

Place yer bets...

petejh

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#76 Re: COVID-19 and the state of politics
April 03, 2020, 06:44:39 pm
It's pretty obvious...they stay in hospital if they are infected.

It's pretty obvious that, in this situation, there is a chain of events that mean this may not be possible. So having a plan for that event is prudent and pragmatic.

I think you are both right, but it’s not up to Offwidth to suggest an alternative.

Of course not, but people might take him more seriously if he could.
« Last Edit: April 03, 2020, 07:08:00 pm by petejh »

Offwidth

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#77 Re: COVID-19 and the state of politics
April 03, 2020, 07:43:52 pm

It's pretty obvious that, in this situation, there is a chain of events that mean this may not be possible. So having a plan for that event is prudent and pragmatic.


Nothing is obvious in that sense at all. Hospital says to Social Care team we have to get Bob out quick as we have run out of space, but he might still  be ill. Social Care team say to Care Manager you need to take Bob back. Care Manager says get stuffed, I'm not risking the others in my home. So then what?   You seriously think the Care Manager (the majority of whom are running a private business) can't refuse?  This is guidance not law. The most likely outcome is we would have Social Care using small hotels to 'park' such patients. Such facilities seem to be popping up already.
« Last Edit: April 03, 2020, 08:01:37 pm by Offwidth »

petejh

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#78 Re: COVID-19 and the state of politics
April 03, 2020, 08:48:46 pm
My thoughts exactly. But that isn't your 'obviously, they stay in hospital if they're still infected'.

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#79 Re: COVID-19 and the state of politics
April 03, 2020, 10:34:05 pm
The hotels are being called hospital extensions. They are in effect there to remove the bedblocking that the NHS had under normal conditions due to the lack of social care capacity and transfer staff overload due to austerity.

TobyD

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#80 Re: COVID-19 and the state of politics
April 03, 2020, 10:51:33 pm
Speeding up the death of the old and vulnerable?

https://www.theguardian.com/society/2020/apr/02/uk-care-home-bosses-threaten-quit-over-return-coronavirus-patients


Isn't this just the sort of triage decision which, unfortunately, covid19 forces medical staff to make?

To put it in the same sensationalist language as you: slowing down the death of the slightly younger and slightly less vulnerable.

It's not triage to put infected people in the place with both the highest risk to others and the least government help in staff preparation and protection to deal with it. I'd say it's the legal H&S duty of care home managers to refuse returned people to their care who have not tested as negative for infection.

I'm sorry offwidth, but you're not right. This is closely related to my job.
The care home manager in the article who says you can't SD in a care home is talking crap, or has been misquoted by the journalist. All the homes I've been into in the last week have had residents confined to rooms, and minimal staff contact, closed to all outside visits except emergencies (mainly medical professionals). That's pretty safe as far as I can see.
« Last Edit: April 03, 2020, 10:58:04 pm by TobyD »

TobyD

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#81 Re: COVID-19 and the state of politics
April 03, 2020, 10:57:02 pm

It's pretty obvious that, in this situation, there is a chain of events that mean this may not be possible. So having a plan for that event is prudent and pragmatic.


Nothing is obvious in that sense at all. Hospital says to Social Care team we have to get Bob out quick as we have run out of space, but he might still  be ill. Social Care team say to Care Manager you need to take Bob back. Care Manager says get stuffed, I'm not risking the others in my home. So then what?   You seriously think the Care Manager (the majority of whom are running a private business) can't refuse?  This is guidance not law. The most likely outcome is we would have Social Care using small hotels to 'park' such patients. Such facilities seem to be popping up already.

Ha, often the most likely outcome is that patients are discharged home on discharge to assess when community services and social care organise how to try and keep them there. This is possible and likely whether or not they've tested positive.

petejh

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#82 Re: COVID-19 and the state of politics
April 03, 2020, 11:02:47 pm
The hotels are being called hospital extensions. They are in effect there to remove the bedblocking that the NHS had under normal conditions due to the lack of social care capacity and transfer staff overload due to austerity.

You started off saying that moving elderly people with covid19 out of hospital was 'Speeding up the death of the old and vulnerable?'
When I asked if you had a better suggestion you stated 'it's pretty obvious... they stay in hospital if infected'.
When I pointed out this might not be possible without compromising a higher-priority patient in these unusual circumstances, you back-peddled to 'The most likely outcome is we would have Social Care using small hotels to 'park' such patients. Such facilities seem to be popping up already.'
When I point out that this isn't the same as: 'it's pretty obvious... they stay in hospital', you change your story to 'The hotels are being called hospital extensions.'
Then Toby points out what is known if you do a little reading around the matter.


If you keep up that back-peddling for much longer you'll be owning up to your own bullshitting before I even point it out ;)


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#83 Re: COVID-19 and the state of politics
April 04, 2020, 09:28:36 am
Speeding up the death of the old and vulnerable?

https://www.theguardian.com/society/2020/apr/02/uk-care-home-bosses-threaten-quit-over-return-coronavirus-patients.

It's not triage to put infected people in the place with both the highest risk to others and the least government help in staff preparation and protection to deal with it. I'd say it's the legal H&S duty of care home managers to refuse returned people to their care who have not tested as negative for infection.

I'm sorry offwidth, but you're not right. This is closely related to my job.
The care home manager in the article who says you can't SD in a care home is talking crap, or has been misquoted by the journalist. All the homes I've been into in the last week have had residents confined to rooms, and minimal staff contact, closed to all outside visits except emergencies (mainly medical professionals). That's pretty safe as far as I can see.

From our previous discussions its clear the places you work with have high standards. However you can't escape the fact that the virus has gone through care homes taking precautions in various countries like a dose of salts. People were left dead in Spain.  So I'd expect better from you than saying a concerned manager was talking crap. You won't know whats safe in terms of if someone infected can be successfully isolated in most UK homes. I know carers, district nurses and social workers assessosrs through old relatives of family and friends. Self isolating is up massively and they are worried about PPE and tests, just like health staff.

https://www.carehomeprofessional.com/breaking-news-government-issues-new-covid-19-admissions-and-care-guidance/

Fultonius

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#84 Re: COVID-19 and the state of politics
April 04, 2020, 12:09:46 pm
Oil Price at $20. bbl is going to do some serious damage to US shale and any other marginal producers around the world. hit for those still in the industry.

I have a pet theory in which I'd like to indulge. I'm musing over things I have no deep understanding in, but just normal levels of interest....

2008 financial meltdown. Government did a load of QE. This stabilised the financial sector, and, while I hate the fact in the neoliberal west we have a steadily diminishing social safety net, the big boys get their seriously fraudulent and risky behaviour "socialised" and we pay for it through 10 years of needless austerity. Most of the QE went straight to shareholders. Basically, QE didn't lead to inflation or high interest rates. The money was borrowed cheaply, but we didn't suffer the oft-touted runaway inflation associated. Not sure I fully understand why? Anyone?

We're now in a similar situation. 25% GDP drop likely on the cards, huge spending to support workers shareholders. Why not take this opportunity to borrow cheaply and spend hard on:

  • Energy transition
  • Environment
  • NHS
  • Schools & Universities
  • High quality energy efficient affordable housing

Spending on these results in the economic multiplier effect, as workers and employees generally spend their earnings, recycle into the economy, pay taxes. On the other hand investors and shareholders hoard wealth, re-invest and generally avoid paying too much tax when they can.

Right, so we have a few existential crises on the horizon - more pandemics. Automation. Ageing population. Climate change.

This is where I get a bit whacky...so bear with me....   This pandemic has shown how fragile the whole system is, it's a big stack of playing cards held up by belief in the money system. Debt is only as real as people believe it is. Climate change is likely* to cause a similar shock or upheaval as this pandemic. At that point, does it matter if we have a heavy burden of national debt? We're never, ever paying it back. There's no intention of that. So why not borrow now, borrow hard and cheap (0.1% base rate, bonds must be mega cheap just now), and invest in the future. Not prop up ailing industries like O&G, but  in the technology and industries of the future. Create jobs, wealth, health and prosperity. We don't even need to nationalise anything. The contracts for difference market in wind (failings aside) shows a model where the government can successfully promote technologies that are properly on the open market for companies to bid on.

If things go bad, then we default. Debt is fictional, and the other alternative is climbing on to dying industries and the inevitable collapse.

Right, chew on that for a while. Keen to promote discussion.

Oldmanmatt

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#85 Re: COVID-19 and the state of politics
April 04, 2020, 12:22:32 pm
1/
Uneducated guess:

QE didn’t lead to rampant inflation, because it was given to people/organisations that didn’t “spend” it.

Give money to us plebs and we buy things , too many things too quickly and create inflationary pressure?

Johnny Brown

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#86 Re: COVID-19 and the state of politics
April 04, 2020, 12:38:22 pm
Quote
...   This pandemic has shown how fragile the whole system is, it's a big stack of playing cards held up by belief in the money system. Debt is only as real as people believe it is. Climate change is likely* to cause a similar shock or upheaval as this pandemic. At that point, does it matter if we have a heavy burden of national debt?

We've got another thread going on this...

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Fultonius

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#88 Re: COVID-19 and the state of politics
April 04, 2020, 01:35:53 pm
Quote
...   This pandemic has shown how fragile the whole system is, it's a big stack of playing cards held up by belief in the money system. Debt is only as real as people believe it is. Climate change is likely* to cause a similar shock or upheaval as this pandemic. At that point, does it matter if we have a heavy burden of national debt?

We've got another thread going on this...

True, missed that. Can a mod move mine post over?

Nigel

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#89 Re: COVID-19 and the state of politics
April 04, 2020, 02:42:43 pm
2008 financial meltdown. Government did a load of QE. This stabilised the financial sector, and, while I hate the fact in the neoliberal west we have a steadily diminishing social safety net, the big boys get their seriously fraudulent and risky behaviour "socialised" and we pay for it through 10 years of needless austerity. Most of the QE went straight to shareholders. Basically, QE didn't lead to inflation or high interest rates. The money was borrowed cheaply, but we didn't suffer the oft-touted runaway inflation associated. Not sure I fully understand why? Anyone?

Just to correct one point there, the money was not "borrowed cheaply", it was "created, for free".

The process of QE and its effects is pretty convoluted and technical. But in a nutshell, QE *did* cause inflation, of a type. It just didn't cause consumer price inflation, as only a small proportion of the money reached the "real" economy i.e. you, me, and businesses, via bank lending. It did cause asset price inflation (stocks and house prices), the benefits of which are necessarily skewed towards the richer demographic. The whys and wherefores of this I can have a go at explaining my understanding of if you are interested!

This is where I get a bit whacky...so bear with me....   This pandemic has shown how fragile the whole system is, it's a big stack of playing cards held up by belief in the money system. Debt is only as real as people believe it is. Climate change is likely* to cause a similar shock or upheaval as this pandemic. At that point, does it matter if we have a heavy burden of national debt? We're never, ever paying it back. There's no intention of that.

In my opinion, no it doesn't matter what the national debt is, at all. The cost of the debt is the main thing. As long as the UK can keep borrowing money at an affordable level we can just keep issuing new gilts to pay off any gilts that come due. This after all is what we have done for pretty much all of history since government debt was invented. At present UK gov can borrow at rock bottom rates, and there is a strong argument that it should load up and use this to invest, as you suggest with your examples.

 

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#90 Re: COVID-19 and the state of politics
April 04, 2020, 04:53:34 pm
Did you read the BOE paper on the other thread Nige (or the discussion with the author I linked)?

His thesis is that interest rates have been declining forever and will continue to do so.

Nigel

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#91 Re: COVID-19 and the state of politics
April 04, 2020, 06:55:16 pm
Did you read the BOE paper on the other thread Nige (or the discussion with the author I linked)?

His thesis is that interest rates have been declining forever and will continue to do so.

No I missed that but have just found the link - 110 pages! Give me a bit of time eh? Something I'm not short of, so I'll get back to you - cheers for the heads up  :thumbsup:

TobyD

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#92 Re: COVID-19 and the state of politics
April 05, 2020, 10:14:31 am
Speeding up the death of the old and vulnerable?

https://www.theguardian.com/society/2020/apr/02/uk-care-home-bosses-threaten-quit-over-return-coronavirus-patients.

It's not triage to put infected people in the place with both the highest risk to others and the least government help in staff preparation and protection to deal with it. I'd say it's the legal H&S duty of care home managers to refuse returned people to their care who have not tested as negative for infection.

I'm sorry offwidth, but you're not right. This is closely related to my job.
The care home manager in the article who says you can't SD in a care home is talking crap, or has been misquoted by the journalist. All the homes I've been into in the last week have had residents confined to rooms, and minimal staff contact, closed to all outside visits except emergencies (mainly medical professionals). That's pretty safe as far as I can see.

From our previous discussions its clear the places you work with have high standards. However you can't escape the fact that the virus has gone through care homes taking precautions in various countries like a dose of salts. People were left dead in Spain.  So I'd expect better from you than saying a concerned manager was talking crap. You won't know whats safe in terms of if someone infected can be successfully isolated in most UK homes. I know carers, district nurses and social workers assessosrs through old relatives of family and friends. Self isolating is up massively and they are worried about PPE and tests, just like health staff.

https://www.carehomeprofessional.com/breaking-news-government-issues-new-covid-19-admissions-and-care-guidance/

This isn't true, I regularly go to some homes which are less than good to put it mildly, I almost contacted the CQC about one of them quite a while ago,  until I talked to the manager and they improved drastically.
I am not relying on second hand reports, Guardian articles or anything else,  just being in them all the time. You can isolate people in a care home. They are certainly under supplied with ppe as is the NHS,  but I don't know if that's because the relevant home owners are just reluctant to buy it: they are always very reluctant to buy in any equipment and often try to pull a fast one by getting the NHS community services to get it for them. I get this all the time.

Carers are massively underpaid,  and often do a great job, but this is separate from the home owners who are often pretty wealthy business people.

On a slightly different topic, there is a lot of misrepresentation of the DNARCPR situation in the media at the moment.  Its got bugger all to do with limited resources or anything else,  I'm no expert but broadly, if you put someone more than 75 in poorish health on ventilation,  you'll probably never successfully wean them off it, and if you do, their quality of life will be appalling. It's a medical decision,  and journalists should respect that, I don't envy doctors having to make them, but I'd trust them to make the best informed judgment,  which is all anyone can ask I think.

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#93 Re: COVID-19 and the state of politics
April 05, 2020, 10:44:29 am
You're dodging my point Toby and building strawmen. I have great respect for care workers, social workers, district nurses, physios, dieticians and all the others involved in the army of social health work. The personal wealth of the owner is irrelevant (unless they are not meeting quality requirements).

The current government guidance is that people can be returned from hospitals to homes untested. Why not answer some straight questions on this. Don't you think it is a H&S responsibility of care homes to control re-admission to those who have been tested as negative? I do. Would you let untested people return if you were running a home? I wouldn't. The Lanarkshire care home disaster shows that internal control measures will often be inadequate if the virus gets inside. Allowing people with the virus back into homes will kill many others in homes. It also puts the staff at risk.

On your ventilator point, the evidence from Italy is those who stay on them a long time face an increasing risk of death. However many don't follow that path and recover quickly and a few do recover after a long time . When the health system is under control we can afford to wait and see; when its overwhelmed, doctors have to play god.
« Last Edit: April 05, 2020, 11:15:22 am by Offwidth »


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#95 Re: COVID-19 and the state of politics
April 06, 2020, 03:02:55 pm
Another article on the nordic countries (thans to Ian Caton in the other channel)

http://theconversation.com/coronavirus-why-the-nordics-are-our-best-bet-for-comparing-strategies-135344


Oldmanmatt

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#97 Re: COVID-19 and the state of politics
April 06, 2020, 08:29:42 pm
Boris is in ICU.


Balls.


I hope he doesn’t fall to this.

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#98 Re: COVID-19 and the state of politics
April 06, 2020, 08:37:06 pm
It will ram home to people how real this shit is... of nothing else.

We all know the odds once people enter ICU :(

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#99 Re: COVID-19 and the state of politics
April 06, 2020, 09:44:33 pm
Shit news.

 

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